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Mayers Memorial Hospital District

Cardiac Rehab Patient Satisfaction Survey

Please tell us about your visit to the MMHD Cardiac Rehabiliation Department
Scoring: P=poor G=good E=excellent
  Date
  Facility - Professional appearance of workout room P
G
E
  Facility - Temperature P
G
E
  Facility - Exercise Equipment P
G
E
  Facility - Adequate parking P
G
E
  Facility - Convenience of Cardiac Rehab times P
G
E
  Facility - Cleanliness of Facility P
G
E
  Facility - Cleanliness of restrooms P
G
E
  Facility - Monthly fees P
G
E
  Staff - Kind and Considerate P
G
E
  Staff - Respectful P
G
E
  Staff - Professional P
G
E
  Staff - Knowledgeable about healthcare of patients P
G
E
  What is the primary benefit of Cardiac Rehab to you?
  Do you feel that the staff understands and tries to meet your needs? Yes
No
  How has your level of fitness changed since you started Cardiac Rehab?
  Would you recommend Cardiac Rehab to your friends who need it? Yes
No
  How many times per week do you come to Cardiac Rehab? 1
2
3
4
  Is the staff friendly and responsive to your questions and concerns? Yes
No
  Suggestions for improving Cardiac Rehab
  Overall impression of the program
  Other comments
  Can we publish your quotes? Yes
No
  Name
Optional
  Email Address
optional